Global clinicoepidemiological pattern of childhood vitiligo: a systematic review and meta-analysis

Farajzadeh, Saeedeh; Khalili, Maryam; Mirmohammadkhani, Majid; Paknazar, Fatemeh; Rastegarnasab, Fereshte; Abtahi‐Naeini, Bahareh

doi:10.1136/bmjpo-2022-001839

Cited by 3 publications

(1 citation statement)

References 29 publications

(48 reference statements)

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“…A meta-analysis of 17 studies involving 4365 subjects, predominantly women, conducted by Farajzadeh et al, revealed varying prevalence rates for non-segmental vitiligo types, with vulgaris, focal, and acrofacial being the most common. Moreover, positive family history varied by region from 13.91% (Asia with 11 studies) to 27.01% (Europe with two studies), and phenomena such as Kobner phenomena and leukotrichia were noted in a significant percentage of patients [17].…”

Section: Introductionmentioning

confidence: 99%

Cutaneous Manifestations in Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED): A Comprehensive Review

Sandru,

Petca,

Dumitrascu

et al. 2024

Biomedicines

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Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), or polyglandular autoimmune syndrome type 1 (PAS-1/APS-1), is a rare autosomal recessive disorder linked to mutations in the autoimmune regulator (AIRE) gene. This review provides a detailed analysis of cutaneous manifestations in APECED, focusing on chronic mucocutaneous candidiasis (CMC), alopecia areata (AA), and vitiligo. The classic triad of hypoparathyroidism, adrenal insufficiency, and CMC serves as a diagnostic cornerstone. However, the varied clinical spectrum of APECED, particularly its cutaneous presentations, poses a diagnostic challenge. CMC, often an early sign, varies in prevalence across populations, including Finnish (100%), Irish (100%), Saudi Arabian (80%), Italian (60–74.7%), North American (51–86%), and Croatian (57.1%) populations. Similarly, AA prevalence varies in different populations. Vitiligo also exhibits variable prevalence across regions. The review synthesizes the current knowledge arising from a narrative analysis of 14 significant human studies published in English up to October 2023. Moreover, this paper underscores the importance of early detection and monitoring, emphasizing cutaneous manifestations as key diagnostic indicators. Ongoing research and clinical vigilance are crucial for unraveling the complexities of this rare autoimmune syndrome and enhancing patient care.

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Section: Introductionmentioning

confidence: 99%

Cutaneous Manifestations in Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED): A Comprehensive Review

Sandru,

Petca,

Dumitrascu

et al. 2024

Biomedicines

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567 - Prognostic factors in pediatric patients with vitiligo

Morales-Sánchez,

Villegas-Calzada,

Acatitla-Acevedo

et al. 2024

British Journal of Dermatology

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Introduction Vitiligo is a pigmentary disorder, and its prevalence reaches 2.16% in children.(1) Childhood vitiligo differs from adult vitiligo in clinical characteristics such as higher incidence in females, higher prevalence of segmental presentation and lower association with autoimmune disorders. (2) The course of vitiligo is unpredictable, the disease may regress, stabilize, progress and exacerbate. (3) Few studies of the course of vitiligo have been published. Objectives The aim of this study was to identify the clinical characteristics associated with the progression of vitiligo in children and adolescents and also to describe the epidemiological profile in our patients. Methods We analyzed the clinical records of a cohort of pediatric patients with vitiligo attended at Centro Dermatológico Dr. Ladislao de la Pascua in Mexico City. Vitiligo diagnosis was defined clinically and to classify patients with NSV we used the revised classification of the Vitiligo Global Issues Consensus Conference. The outcome was the progression of vitiligo, and it was defined as an increase in the extent of the disease at the last visit of follow-up of the patient. We extracted the following data: age at onset, presence of halo nevus, Koebner phenomenon, familial medical history of vitiligo, presence of autoimmune and thyroid disorders. The Koebner phenomenon was considered if lesions were present in areas of friction or if the parents reported their occurrence at sites of previous trauma. Statistical analysis was performed using software SPSS v.25. To calculate the follow-up time we calculate the number of days between the last visit to the first visit of the participant to the center. We define four states according to the clinical course of vitiligo: stable, partial remission, complete remission and progressión. Stable means that the affected body surface area (BSA) did not change over the time, partial remission that the BSA decreased, complete remission means a BSA equal to zero and progression an increase in the involved BSA. We made a survival analysis using Kaplan Meier curves. Results Of the 679 participants, 50.2% (341) were males and 49.8% (338) females, giving a male-to-female ratio of 1:1. The average age of onset was 8.6 years (SD 4.4 years). Non-segmental vitiligo (NSV) was more common (55.5%) than segmental vitiligo (44.5). Koebner’s phenomenon was observed in 22.5% of patients and halo nevus was diagnosed in 5% of them. Only 4.1% (28) of the patients had family history of vitiligo; 0.9% had thyroid disorders and 0.3% had been diagnosed with an autoimmune disorder. The mean time of follow up was 11 months. The clinical course of the patients was: stable 44.3%, partial remission 38.7%, complete remission 4.9% and progression in 12.1%. The median time to progression of vitiligo was 71 months equivalent to 5.9 years (95%CI 58.72-83.29 months). The mean time to progression for non-segmental vitiligo was 54.94 months vs. 61.94 patients with segmental vitiligo (p=0.087). Time to progression was different in patients with another skin disease 68.37 months vs. 54.53 months (p=0.015). There were no differences in time to progression for the following variables: treatment, age of onset, gender, family history, Koebner phenomenon, halo nevus and autoimmune disorders. Conclusions In our population childhood vitiligo has a slow progression rate and a low prevalence of family history and Koebner's phenomenon compared to other Latin American populations. (4) The ratio of non-segmental to segmental vitiligo and female to male were lower than other countries. (5) Studies with longer follow-up periods are needed to assess progression in vitiligo.

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Protocol for a systematic review and meta-analysis on Janus kinase inhibitors in the management of vitiligo

Pranić,

Pulumati,

Vuković

2024

Syst Rev

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Background Vitiligo is a disease that affects people of all skin shades and can impact their quality of life. Reliable evidence on the effectiveness and adverse events associated with the recent use of Janus kinase (JAK) inhibitors to treat vitiligo is needed. This protocol for a systematic review and meta-analysis seeks to collect evidence from both randomized controlled trials (RCTs) and observational studies to determine the effectiveness and patient-centered outcomes concerning treatment with JAK inhibitors. Methods We will conduct a systematic review of the literature for RCTs and observational studies that used upadacitinib, ritlecitinib, brepocitinib, ifidancitinib, cerdulatinib, deglocitinib, baricitinib, tofacitinib, and ruxolitinib JAK inhibitors as treatments for vitiligo compared to placebo, no treatment, or combination therapies. We will systematically search from inception in Epistemonikos, MEDLINE, Scopus, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, PsycINFO, Allied and Complementary Medicine Database, Latin American and Caribbean Health Sciences Literature, Web of Science Core Collection, relevant preprint servers, and the gray literature. Ethics approval was not sought as the protocol and systematic review will not involve human participants, but rather summarized and anonymous data from studies. Primary outcomes include quality of life, percentage repigmentation, decreased vitiligo within 1 year or more, lasting repigmentation after a 2-year follow-up, cosmetic acceptability of repigmentation and tolerability or burden of treatment, and adverse events. Secondary outcomes are patient and study characteristics. We will include full-text articles, preprints, and clinical trial data in any language and all geographic regions. For data sources unavailable in English, we will obtain translations from global collaborators via the Cochrane Engage network. We will exclude articles for which sufficient information cannot be obtained from the authors of articles and systematic reviews. At least two investigators will independently assess articles for inclusion and extract data; reliability will be assessed before subsequent selection and data extraction of remaining studies. The risk of bias and certainty of evidence with Grading of Recommendations Assessment, Development, and Evaluation guidelines will be assessed independently by at least two investigators. We will estimate treatment effects by random-effects meta-analyses and assess heterogeneity using I2. Data that cannot be included in the meta-analysis will be reported narratively using themes. Discussion The proposed systematic review and meta-analysis describe the methods for summarizing and synthesizing the evidence on the effectiveness and patient-centered outcomes concerning the treatment of vitiligo with JAK inhibitors that were recently approved for this indication. To disseminate further the results of our systematic review, we plan to present them at international conferences and meetings. Our findings will provide robust evidence to facilitate decision-making at the policy or practitioner level. Systematic review registration PROSPERO CRD42023383920.

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Global clinicoepidemiological pattern of childhood vitiligo: a systematic review and meta-analysis

Cited by 3 publications

References 29 publications

Cutaneous Manifestations in Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED): A Comprehensive Review

Cutaneous Manifestations in Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED): A Comprehensive Review

567 - Prognostic factors in pediatric patients with vitiligo

Protocol for a systematic review and meta-analysis on Janus kinase inhibitors in the management of vitiligo

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